Body weight changes in breast cancer patients following adjuvant chemotherapy and contributing factors

Abstract

Abstract. Weight gain commonly occurs in breast cancer patients who receive adjuvant chemotherapy. Weight gain may cause psychosocial stress and is associated with patient prognosis and survival. Several factors contributing to weight gain have been identified in Western populations. However, there was lack of information associated with body weight changes following adjuvant chemotherapy in Chinese breast cancer patients. To the best of our knowledge, this is the first such study to be conducted in the Chinese population. A total of 98 patients who received adjuvant chemotherapy following a modified radical mastectomy were included in this study. Their weight was measured prior to the first and following the last cycle of chemotherapy. A weight gain, or loss, of >1 kg following adjuvant chemotherapy was considered to be significant. Cancer stage, treatment modalities, menopausal status and other clinical information were obtained through medical record review. The results revealed that the weight changes ranged from -11 to +9 kg, with a mean value of -0.4±4.4 kg. A total of 66.7% of the patients exhibited weight changes (34.6% gained >1 kg and 32.1% lost weight), whereas 33.3% of the patients maintained a stable weight (P<0.001). Patients aged ≤40 years [odds ratio (OR)=1.429, P=0.028], with a weight of ≥60 kg at diagnosis (OR=2.211, P=0.023), who received ≥4 cycles of chemotherapy (OR=1.591, P=0.039) and a total hormone dose of ≥200 mg (OR=2.75, P=0.013) exhibited a higher risk of weight gain. In conclusion, the body weight changes observed in Chinese breast cancer patient post-adjuvant chemotherapy were different from those observed among Western populations, represented predominantly by weight gain and were reflected by approximately equal percentages of weight gain, stable weight and weight loss. IntroductionOver the previous two decades, weight gain has been shown to be a dominant event among Western breast cancer patients following adjuvant chemotherapy, exerting a negative effect on the quality of life of the patients, since weight gain is associated with secondary diseases, such as diabetes and cardiovascular diseases (1-7). Furthermore, weight gain is also associated with cancer recurrence and poor prognosis (8-13). Several previous studies have demonstrated that the majority of breast cancer survivors exhibited a mean body weight gain of 1-6 kg following chemotherapy and identified adjuvant chemotherapy as an independent prognostic factor for weight gain, with a potential long-term effect (2,3,5,6,11). However, other studies did not report a significant difference in weight gain between breast cancer patients receiving adjuvant chemotherapy and healthy controls (14). Therefore, the frequency and extent of body weight gain reported by previous studies may be considered to be overestimated (14,15).The causes of weight gain may include reduced physical activity and menopause prior to diagnosis. However, the exact mechanisms have not been fully elucidated. In addition, the previous observations were focus...

Body weight changes after adjuvant chemotherapy of patients with breast cancer: results of a Mexican cohort study

“…The larger prospective studies of the National Cancer Institute, such as the Women's Healthy Eating and Living Study (Wang et al., ) conducted in >3,000 early‐stage BC survivors, and the Health, Eating, Activity, and Lifestyle Study, which has enrolled about 1,200 women with early‐stage BC, have reported weight changes similar to those observed in the present study. In both of those studies, chemotherapy was significantly associated with weight gain up to 6 years after diagnosis.…”

“…Some studies have demonstrated a weight increase in pre-menopausal women, but not all investigations support this particular condition (Ingram & Brown, 2004;Vance et al, 2011). Other studies have demonstrated that the continued use of steroids during chemotherapy, to treat side effects like nausea and vomiting, is associated with significant weight gain during treatment (Demark-Wahnefried et al, 2001;Wang et al, 2014). Antracyclin-based chemotherapy (like most of the patients received in this cohort study) is also associated with less weight gain, but our findings are not consistent with that evidence (Trédan et al, 2010).…”

“…Gaining weight during and/ or after BC treatment can cause psychosocial stress, which is directly associated with a worsening of the prognosis and survival. Weight gain can also contribute to other long-term health risks (Makari-Judson, Judson, & Mertens, 2007;Wang, Cai, Wang, Zhang, & Zhang, 2014) and is more common in patients receiving adjuvant chemotherapy, especially with longer treatments. It seems especially pronounced in pre-menopausal women and among those treated with a multi-agent regimen (Reddy et al, 2013;Thivat et al, 2010).…”

Variação ponderal e quimioterapia em mulheres com câncer de mama atendidas em serviço público

“…Ao comparar o peso das mulheres antes e após / durante o tratamento quimioterápico, ao contrário do que se esperava (ganho ponderal) 10,13,14,20,23 , observou-se média de peso semelhante entre os dois períodos, sem significância estatística, enquanto que pouco mais da metade das mulheres estudadas perderam peso durante tratamento quimioterápico, e a outra metade, um pouco menos, apresentou ganho ponderal.…”

“…Além disso, o tratamento quimioterápico é capaz de influenciar negativamente o estado nutricional, segundo os indicadores do Índice de Massa Corporal (IMC) [7][8][9][10] . Embora o tratamento auxilie no aumento da sobrevida livre da doença e da sobrevida global de mulheres com câncer de mama 9,11 , é capaz de acentuar os efeitos nutricionais adversos do câncer, com consequente esgotamento das reservas de nutrientes 12 , além de um preocupante fator como o estímulo ao ganho de peso 13,14 .…”